August 2018
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Aug 20 2018
LOWMAGHI – Magnesium for Afib Rate Control
Among patients with atrial fibrillation with rapid ventricular response, low-dose magnesium (4.5g over 30 minutes) is an effective adjunct to standard therapy compared to placebo and causes far fewer side effects than high dose magnesium.
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Aug 18 2018
Flu Tests in Summer and Other Bad Ideas
Why is it a bad idea to test for flu during the summer, in a time of low prevalence? Because the PPV decreases as prevalence decreases. Any positive test you get is more likely than not to be a false positive.
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Aug 17 2018
Head Ultrasound Can’t Screen for Trauma in Infants
Head ultrasound (HUS) via open fontanelle was a poor screening tool for intracranial bleed due to accidental or inflicted trauma.
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Aug 16 2018
LR vs NS for Pediatric DKA
Use of any LR in pediatric patients with DKA, as opposed to only NS, was associated with lower overall costs, similar length of stay, and markedly reduced incidence of cerebral edema in this retrospective study.
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Aug 15 2018
New CATCH2 Highly Sensitive for Pediatric Brain Injury
CATCH2 is the CATCH rule plus ≥4 episodes of vomiting. It was highly sensitive for neurosurgical intervention and predicting injury on CT.
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Aug 14 2018
Lytics for Mild Stroke Disastrous
Not surprisingly, patients with mild, non-disabling stroke did not benefit from receiving alteplase over aspirin. If anything, the trend favored aspirin. Five patients (3.2%) who received alteplase had intracranial hemorrhage.
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Aug 13 2018
Who’s Giving Inappropriate Antibiotics – Urgent Care, Retail, Emergency, or Medical Office?
Urgent care centers wrote the most inappropriate antibiotic prescriptions for viral respiratory illnesses. They were followed by the ED, medical offices, and finally by retail health clinics.
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Aug 11 2018
Stumbling Into a Diagnosis
A 9 year old presented with what we thought was cancer. Read how we stumbled into the diagnosis.
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Aug 10 2018
Risk of Emergent Thoracotomy
ED thoracotomy was associated with a risk of exposure to blood or body fluid in 7.6% of the 305 cases and 1.6% of the 1360 participants.
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Aug 09 2018
Unnecessary Urgent Care to Emergency Transfers
In this single center, 27% of urgent care to pediatric emergency department transfers were likely unnecessary and resulted in discharge with no ED resource utilization.